Pulmonary Manifestations of Cryptococcosis in Patients with AIDS

The computed tomographic (CT) scans and chest radiographs of 10 patients with AIDS and proven pulmonary cryptococcal infections were reviewed. In seven patients (70%), CT demonstrated pulmonary opacities that ranged in appearance from a perihilar interstitial pattern to an area of dense alveolar consolidation. Corresponding chest radiographs were less accurate in detecting interstitial opacities (2 of 5 patients, 40%) than the alveolar opacities (4 of 5 patients, 80%). Pulmonary nodules were identified in three patients (30%) by CT but were identifiable on the chest radiograph in only one patient (10%). The chest radiograph suggested hilar adenopathy in three patients although CT confirmed hilar adenopathy in only one patient. In one patient, a small pleural effusion, not appreciated on the chest radiograph, was detected by CT. CT may add additional information in the diagnosis of pulmonary Cryptococcus neoformans.